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City of Santa Ana <br />r Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements <br />have been satisfied prior to signing the termination form. <br />Is the agreement(s) a permanent record? Yes No <br />Return form to the Clerk of the Council Office (,M-30). <br />Call 647-1520 if you have any questions. <br />The agreement with 1 <br />No. N-2022-356 was completed on <br />(List all amendments. Use space below if needed.) <br />Department: LA A <br />COTC Office Use Onl <br />. �3 <br />City of Santa Ana, <br />JAIL 1.1 2024 <br />City Claret's Cf e <br />�Ql�lfo *q <br />COMPY's) <br />(Irvine <br />i:lagreernents*rmsltorm - agreement termination form_goldenrod.doc <br />and final payment has been made. <br />Phone/Ext.: <br />Signature: i <br />Date: <br />